19 Ways to Beat Stress

When the university’s MHealthy team polled University of Michigan employees last year
about their health, they found that 60 percent of those surveyed were at moderate
or high risk for stress. Even positive events like vacations and pay raises can bring
it on. Lorna Hurl, a counselor with the UM Faculty and Staff Assistance Program who
conducts stress-management workshops for MHealthy, says the more vulnerable we are
to the little stressors, the more trouble we’re likely to have with the big ones.
Here, from experts at MHealthy and the School of Public Health, are 19 steps you can
take to boost your stress immunity:

1. Breathe

When issues or events of the day threaten to overwhelm you, inhale slowly and deeply
through your nose to a count of six, allowing air to fill your lungs. Hold your breath
for a count of four, then exhale slowly and completely while counting to six again.
Repeat six or more times. This steadying, calming exercise increases the amount of
oxygen to the brain and helps relieve tension. Says SPH alumna Molly Miklosovic, MPH
’03, project facilitator for MHealthy Mental and Emotional Health, “If we could emphasize
any single stress-management activity, it would be this: breathe.”

2. Get moving

Ride a bike. Lift weights. Swim. Moderate physical exercise has been shown to increase
resilience to stress by stimulating neuronal activity in parts of the brain that are
involved in emotional processing. Exercise also helps relieve the tension that results
when stress prompts the release of the hormones cortisol and adrenaline.

3. Practice mindfulness

Unconscious thoughts can support or undermine the ability of the body and mind to
relax, says SPH alumna Angela Precht, MPH/MSW ’07, program coordinator for the MHealthy
Tobacco Independence Program. “Mindfulness helps us be aware of our thoughts, feelings,
and emotions, making it easier to deal with them productively.” To foster mindfulness,
try activities like yoga and meditation.

4. Meditate

MHealthy recommends this approach to basic meditation: Sit in a comfortable chair.
Slowly stretch your neck, then roll your head around. Close your eyes, focus on your
breathing, inhale, and then exhale while saying a mantra to yourself. It could be
something as simple as “I am at peace.” Do this for five minutes; build up to 20–30
minutes.

5. Get by with a little help from your friends

Cultivate a social support network. Friends and family can help you appraise a stressful
situation, figure out what’s at stake for you, and give advice. In social-scientific
terms, they suggest coping responses—cognitive or behavioral ways of changing your
response to stress.

6. Talk to strangers

Sometimes the people who can help you most are those who know you least—bartenders,
waitresses, hairdressers. You see them every now and then, and that makes it possible
to “almost unburden yourself to them,” says Neal Krause, SPH professor of health behavior
and health education, who has researched stress for the past 25 years.

7. See a pro

Whether it’s a therapist, social worker, or member of the clergy, professional counselors
not only help you unburden, but they can also help you appraise a situation and determine
a course of action.

8. Get enough ZZZ's

Aim for seven to eight hours a night, at least four nights a week. Sleep helps keep
your immune system functioning, decreases stress-hormone levels, and can improve mood
and concentration.

9. Go to work

SPH Professor Neal Krause cites the early 20th-century German social theorist Georg
Simmel, who believed “the salvation of the soul depends on each and every person’s
wrestling from himself the most personal and unique elements of his being, real in
conception but not yet pure in form.” The experts at MHealthy encourage you to develop
a personal mission statement, which can help you know when to say yes or no to demands
on your time and energy.

10. Pause

Take regular time-outs from work. The simple act of leaving your desk or work station
for a short walk can help you cool down and re-process. Use breathing techniques.
Take small breaks throughout the day. Reward yourself for tasks accomplished. A ten-minute
break from the office—or a longer vacation—can change your perspective.

11. Take charge

The scientific literature says people who feel their environment is responsive to
their efforts to change it fare better than people who feel they lack control. One
way to reassert control when confronted by a stressful situation is to sit down and
force yourself to consider problem-solving steps, then give yourself enough time to
work through them. If you can’t do it alone, seek help from others, whether friends
or professionals.

12. Give

To others. In a longitudinal study of the effects of economic difficulty on mortality,
SPH Professor Neal Krause asked older people what helped them the most—receiving support
or giving it. Giving turned out to be more beneficial than receiving. Why? “It elevates
your sense of self-esteem, your self-worth,” Krause explains. People who are going
through difficult financial times can often be highly self-critical. “But doing something
good for someone else helps short-circuit that. It also gives you a respite: you get
outside your own world and stop ruminating on your own problems and think about somebody
else’s problems for a while.”

13. Strike a balance

Strive for a comfortable blend of work, family, challenge, and fun. Challenges, in
particular, engage you and release energy in a good way and promote positive stress,
or eustress. “We need a certain amount of adrenaline,” MHealthy’s Lorna Hurl says.
Make sure there’s pleasure in your life.

14. Reframe

Situations and events aren’t inherently stressful—they vary according to individuals’
perceptions. Events that are enormously stressful for some may not bother others.
Much has to do with our personalities, personal histories, resources, and circumstances.
Figure out what gets your goat, and work to change the way you view things. Practice
the tenets of cognitive behavioral change: identify distortions, examine the evidence,
think in shades of gray, talk to yourself in the same compassionate way as you would
a friend who’s in trouble.

15. Identify

Find out how your body responds physiologically to stress, so that you can recognize
and address the symptoms as they appear. Maybe you get a headache or a cold, or have
trouble sleeping, or become angry, distracted, or forgetful. Take a break; try a breathing
exercise (see #1). Learn what works. Recognize your stressors, too—big and small.
Sometimes just knowing what’s upsetting you can alleviate strain.

16. Nurture yourself and others

“Begin by taking care of your own physical, social, and emotional needs,” says MHealthy’s
Lorna Hurl. “Taking time for yourself can help calm and relax you.” Get enough food,
sleep, and exercise, but also work at building strong social networks. Hurl says the
acts of “tending and befriending” can help keep stressors in perspective, provide
a positive outlet for tension, and increase feelings of friendship, support, and productivity.

17. Worship

Most of the world’s sacred texts are “how-to” manuals for coping with stress, says
SPH Professor Neal Krause, who studies the role of religion in stress reduction. Religion
appears to help reduce the effects of stress, though “not always and not for all people.”
The key seems to be getting together as a group to reflect on religious teachings,
such as forgiveness and charity. Whether collective reflection through secular groups
like the Rotary Club has the same effect is a question Krause is still studying.

18. Be quiet

Our loud and fast-paced world can create stressful “noise” in our lives, notes MHealthy’s
Angela Precht, who suggests carving out a scheduled quiet space in your day to renew
and reflect. “Whether it’s a ten-minute walk with your dog or radio-free time in the
car, a few moments of truly quiet time can be refreshing.” And don’t forget the “noise”
of technology. E-mail, text messages, voice mail, and the like may be indispensable
to our 24/7 existence, but they also foster stress. Find times and ways to tune out
and turn off.

19. Act “as if”

If you behave as though you’re happy and competent, it can become a self-fulfilling
prophecy. When you get angry, for instance, try acting as if you’re not angry. When
you feel insecure, act as if you’re sure of your competence. “The idea,” says Lorna
Hurl of MHealthy, “is to go through the routines of life as if you are comfortable
and enjoying them—despite the fact that initially it feels forced—and continue doing
this until the comfort becomes real. This works because our behavior influences or
shapes our feelings.”

The Four (4) Kinds of Stress

Daily hasslesAlthough they’re short- lived and have little impact, these stressors can be the proverbial
straw that breaks the camel’s back.

Stressful life eventsThis category includes a range of experiences, from relocation to unemployment to
a new baby. Most experts agree the impact of these stressors lasts 18 months or less.

Lifetime traumaAn earthquake, a war, the death of a child: events like this are indelible, and their
effect, says SPH’s Neal Krause, can be “off the charts.”

Chronic strainsThese are stressors that don’t dissipate, such as poverty and racial discrimination.

On the Job: Workplace Stress (and Its Prevention) at Michigan

Job stress is thought to cost U.S. industry more than $300 billion a year in absenteeism,
turnover, diminished productivity, and medical, legal, and insurance costs. So when
an employee-wellness survey revealed last year that stress is one of the most prevalent
health risk factors in the University of Michigan population, the leadership at MHealthy—a
university-wide employee wellness initiative launched by President Mary Sue Coleman—convened
a stress-management task force.

The idea, says SPH alumna Molly Miklosovic, MPH ’03, who facilitates MHealthy’s mental and emotional health program, was to take a “more
comprehensive, more preventive approach to stress. We wanted to look at the work people
do and the culture in which they do that work.”

Regular high stress heightens people’s risk for a number of physical and mental conditions,
including depression, anxiety, upset stomach, high blood pressure, high heart rate,
sleep disturbances, type 2 diabetes, and headaches. Stress can also lead to difficulty
concentrating, shortness of temper, job dissatisfaction, and low morale.

At a place like Michigan, which relies on the productivity and engagement of its employees,
symptoms like these can be disastrous.

The MHealthy task force conducted a thorough review and discussion of UM data, evidence-based
research literature, and benchmarking results and came up with a comprehensive stress–prevention
and management program—with recommendations at all levels: individual, group, and
organizational. Today MHealthy offers a variety of stress-related classes to both
faculty and staff as part of its annual rewards program and throughout the year. Topics
include stress management as well as parenting and anger management, and classes can
be taken online, on paper, or in person through the university’s two employee-assistance
programs.

Miklosovic, who says her primary interest is “organizational health,” notes that effective
stress-management programs benefit both employers and employees. MHealthy is looking not only at individual responses to stress but “at the organization
as a whole, and how we can promote psychological health and well-being in the workplace,”
Miklosovic says. Laurita Thomas, UM associate vice president for human resources,
says MHealthy’s emphasis on stress management speaks to the university’s commitment
to “a culture of health that recognizes the mental and emotional aspects as essential
components of wellness.”

MHealthy currently employs the following SPH graduates:

Bethany Lemm, MPH/ MSW ’02

Molly Miklosovic, MPH ’03

Lindsey Mitchell, MPH ’07

Alison Nix, MPH ’02

Angela Precht, MPH/MSW ’07

Karen Schmidt, MPH ’99

Susan Sutorka, MPH ’04.

Peggy Sheagren, MPH ’89, is the former director of MHealthy Operations.

John Sonnega, program manager for MHealthy’s new stress-management initiative, is
a member of the SPH-affiliated Prevention Research Center of Michigan.

Six (6) Steps Managers Can Take to Reduce Workplace Stress

Support a work/life balanceHelp staff maintain realistic workloads and flexible schedules (as appropriate), and
encourage the practice of “taking care of your own.”

Practice A+ communicationMake sure everyone on your team has clearly defined roles and responsibilities. Check
in to see how people are doing; share important information clearly and openly; and,
when possible, include employees in conversations or decisions that affect their work.

Ask themEvery employee is different, as is every workplace. Identify the stressors in your
department and solicit suggestions as to how you and/or the department in general
can realistically help reduce stress levels.

Create and support a healthy workplace cultureCultivate positive relationships; encourage action towards health and well-being;
and make sure department actions are consistent with your organization’s mission,
vision, and values. Set realistic goals.

Set a positive exampleYour mom was right about the “Golden Rule”—treat others the way you want to be treated.
Use exemplary communication, strive for positive interactions, and set an example
of how to take good care of yourself and your staff.

Be proactiveIn a perfect world, we would all avoid stressors before they became a problem. Together
with staff members, brainstorm actual and potential stressors and healthy ways to
avoid or resolve them. If you see employees who are struggling, find out what you
can do to help them move forward productively.